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Organization

MOSAIC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SCOTT HOFFMAN (SR VP & CHIEF FINANCIAL OFFICER)
(402) 896-3884
Entity
Organization

Contact information

Practice address
8816 N INDUSTRIAL RD, SUITE B, PEORIA, IL 61615-1553
(309) 693-8115
(309) 693-8116
Mailing address
4980 S 118TH ST, OMAHA, NE 68137-2220
(402) 896-3884
(402) 894-4780

Taxonomy

Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
IL

Other

Enumeration date
01/04/2007
Last updated
07/21/2022
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